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Having a hiccup in your heart rhythm can be uncomfortable – as well as frightening. But when does an extra heartbeat or other unexpected feeling warrant a visit to your doctor?
John Hummel, MD, a heart rhythm specialist at the Richard M. Ross Heart Hospital, sheds some light on irregular heart rhythms, which are fairly common.
“It can be tempting to jump to the worst-case scenario when it comes to your heart, and to think that an irregular heartbeat is a sign of a serious disease,” says Dr. Hummel. “But it doesn't always require treatment.”
The possible causes of an irregular heartbeat can vary widely – from too much caffeine to a more potentially dangerous condition of having your blood pressure skyrocket or plummet.
There are several types of irregular heartbeats. Dr. Hummel explains some people experience an extra heartbeat, a skipped beat, too fast of a beat (called tachycardia) or too slow of a beat (called bradycardia).
When to see a doctor immediately?
Dr. Hummel says it can be difficult for most people to know if an irregular heartbeat is a sign of something more serious.
- Normal hearts beat 60—100 times every minute. When your heart beats more than 100 times each minute, that’s considered high (called tachycardia in the medical world). Fast heartbeats can last for seconds to hours. Not all cases of a racing heartbeat are dangerous.
- An athletic teenager may have a heart rate of 50 at rest but could have heart rate of 180 during heavy exercise. To check your child's pulse or heart rate, gently feel for a slight beat inside the wrist, the crook of the elbow, or side of neck. Count beats for 15 seconds, and then multiply by 4.
- Your pulse is your heart rate, or the number of times your heart beats in one minute. Pulse rates vary from person to person. Your pulse is lower when you are at rest and increases when you exercise (more oxygen-rich blood is needed by the body when you exercise). Knowing how to take your pulse can help you evaluate your exercise program.
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Go immediately if you have additional symptoms with your irregular heartbeat or you’ve had a heart attack or other heart stress. According to Dr. Hummel, those symptoms include fainting, dizziness, chest pain, swelling in your leg or shortness of breath.
“There’s a big difference between sitting in a chair and noticing your heart skipping and having fluttering that makes you feel like I’m going to pass out,” says Dr. Hummel.
“The other issue is whether your heart is structurally normal. If it’s not, abnormal heart rhythms more commonly will increase your risk of stroke or sudden death.”
Look at your actions and environment
Dr. Hummel says external factors could be causing disruptions in your heart rhythm:
- Too much caffeine or alcohol
- Dehydration
- Drug abuse
- Fever
- Anemia
- Emotional distress
- Sleep apnea
- Pregnancy
- Eating or exercising
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Dr. Hummel advises you make notes of when you experience irregular heartbeats and share this information with your doctor. Remember, not all unusual heart rhythms will require treatment. 'Abnormal heartbeats can come and go, especially in young people,” states Dr. Hummel.
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What type of tests can help diagnose an irregular heartbeat?
The first test is usually an echocardiogram, which looks at the structure and function of your heart. You may have an exercise stress test on a treadmill or stationary bike to measure your heart’s response to exertion. Patients might also be asked to wear a portable monitoring device (called a Holter monitor) for 24 to 48 hours that records every heartbeat and monitors for irregular heart rhythm.
“We have a wide range of diagnostic tools and we work to figure out what the cause is by looking at your actions and your medical history,” explains Dr. Hummel. He points out some people may have an inherited abnormal heart rhythm. Learn more about genetic heart testing.
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The bottom line on your irregular heartbeat
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- If you have skipped heartbeats, you need to pay attention to your body and then get an assessment.
- The urgency of that assessment is determined by whether you have additional symptoms or structural heart disease.